BACK TOTOP Browse A-ZSearchBrowse A-ZABCDEFGHIJKLMNOPQRSTUVWXYZ0-9 E-mail FormEmail ResultsName:Email address:Recipients Name:Recipients address:Message: Print-FriendlyBookmarksbookmarks-menuIntracardiac electrophysiology study (EPS)Electrophysiology study - intracardiac; EPS - intracardiac; Abnormal heart rhythms - EPS; Bradycardia - EPS; Tachycardia - EPS; Fibrillation - EPS; Arrhythmia - EPS; Heart block - EPSIntracardiac electrophysiology study (EPS) is a test to look at how well the heart's electrical signals are working. It is used to evaluate abnormal heartbeats or heart rhythms.Heart rhythmsAn arrhythmia is a disorder of the heart rate (pulse) or heart rhythm. The heart can beat too fast (tachycardia), too slow (bradycardia), or irregul...ImageRead Article Now Book Mark Article Related video goes here for no-HTML5 browsers How the Test is Performed Wire electrodes are placed in the heart to do this test. These electrodes measure electrical activity in the heart.The procedure is done in a hospital laboratory. The staff will include a cardiologist, technicians, and nurses. To have this study:Your groin and/or neck area will be cleaned and numbing medicine (anesthetic) will be applied to the skin. The cardiologist will then place several IVs (called sheaths) into the groin or neck area. Once these IVs are in place, wires or electrodes can be passed through the sheaths into your body. The doctor uses moving x-ray images (fluoroscopy) to guide the catheter into the heart and place the electrodes in the right places. The electrodes pick up the heart's electrical signals. Electrical signals from the electrodes may be used to make the heart skip beats or produce an abnormal heart rhythm. This can help the doctor understand more about what is causing the abnormal heart rhythm or where in the heart it is starting. You may also be given medicines that may also be used for the same purpose. Other procedures that may also be done during the test:Placement of a heart pacemaker PacemakerA pacemaker is a small, battery-operated device. This device senses when your heart is beating too slowly. It sends a signal to your heart that mak...ImageRead Article Now Book Mark Article Procedure to modify small areas in your heart that may be causing your heart rhythm problems (called catheter ablation) Catheter ablationCardiac ablation is a procedure that is used to scar small areas in your heart that may be involved in your heart rhythm problems. This can prevent ...Read Article Now Book Mark Article No audio descriptionWith audio descriptionRelated video goes here for no-HTML5 browsersRelated video goes here for no-HTML5 browsers How to Prepare for the Test You will be told not to eat or drink for 6 to 8 hours before the test. You will wear a hospital gown. You must sign a consent form for the procedure.Your health care provider will tell you ahead of time if you need to make changes to the medicines you regularly take. Do not stop taking or change any medicines without first talking to your provider.In most cases, you will be given medicine to help you feel calm before the procedure. The study can last from 1 hour up to several hours. You may not be able to drive home afterward, so you should plan for someone to drive you. How the Test will Feel You will be awake during the test. You may feel some discomfort when the IV is placed into your arm. You may also feel some pressure at the site when the catheter is inserted. You may feel your heart skipping beats or racing at times. Why the Test is Performed Your provider may order this test if you have signs of an abnormal heart rhythm (arrhythmia).ArrhythmiaAn arrhythmia is a disorder of the heart rate (pulse) or heart rhythm. The heart can beat too fast (tachycardia), too slow (bradycardia), or irregul...ImageRead Article Now Book Mark Article You may need to have other tests before this study is done. An EPS may be done to:Test the function of your heart's electrical system Pinpoint a known abnormal heart rhythm (arrhythmia) that is starting in the heart Decide the best therapy for an abnormal heart rhythm Determine whether you are at risk for future heart events, especially sudden cardiac death See if medicine is controlling an abnormal heart rhythm See whether you need a pacemaker or implantable cardioverter-defibrillator (ICD) Implantable cardioverter-defibrillatorAn implantable cardioverter-defibrillator (ICD) is a device that detects a life-threatening, rapid heartbeat. This abnormal heartbeat is called an a...ImageRead Article Now Book Mark Article What Abnormal Results Mean Abnormal results may be due to abnormal heart rhythms that are too slow or too fast. These may include:Atrial fibrillation or flutter Atrial fibrillationAtrial fibrillation (Afib) and atrial flutter are common types of abnormal heart rhythms (arrhythmias) which affect the upper chambers (atria) of the...ImageRead Article Now Book Mark Article Heart block Sick sinus syndrome Sick sinus syndromeNormally, the heartbeat starts in an area in the top chambers of the heart (atria). This area is the heart's pacemaker. It is called the sinoatrial...ImageRead Article Now Book Mark Article Supraventricular tachycardia (a collection of abnormal heart rhythms that start in the upper chambers of the heart) Supraventricular tachycardiaParoxysmal supraventricular tachycardia (PSVT) is episodes of a rapid heart rate that start in a part of the heart above the ventricles. "Paroxysmal...ImageRead Article Now Book Mark Article Ventricular fibrillation and ventricular tachycardia Ventricular tachycardiaVentricular tachycardia (VT) is a rapid heartbeat that starts in the lower chambers of the heart (ventricles).ImageRead Article Now Book Mark Article Wolff-Parkinson-White syndromeWolff-Parkinson-White syndromeWolff-Parkinson-White (WPW) syndrome is a condition in which there is an extra electrical pathway in the heart that leads to periods of rapid heart r...ImageRead Article Now Book Mark Article There may be other causes that are not on this list.The provider must find the location and type of heart rhythm problem in order to determine the proper treatment. Risks The procedure is very safe in most cases. Possible risks include:Arrhythmias Bleeding Blood clots that lead to embolism EmbolismBlood clots are clumps that occur when blood hardens from a liquid to a solid. A blood clot that forms inside one of your veins or arteries is calle...ImageRead Article Now Book Mark Article Cardiac tamponade Cardiac tamponadeCardiac tamponade is pressure on the heart that occurs when blood or fluid builds up in the space between the heart muscle and the outer covering sac...ImageRead Article Now Book Mark Article Heart attack Heart attackMost heart attacks are caused by a blood clot that blocks one of the coronary arteries. The coronary arteries bring blood and oxygen to the heart. ...ImageRead Article Now Book Mark Article Infection Injury to the vein Low blood pressure Low blood pressureLow blood pressure occurs when blood pressure is much lower than normal. This means the heart, brain, and other parts of the body may not get enough...ImageRead Article Now Book Mark Article Stroke Open ReferencesReferencesFerreira SW, Mehdirad AA. The electrophysiology laboratory and electrophysiologic procedures. In: Sorajja P, Lim MJ, Kern MJ, eds. Kern's Cardiac Catheterization Handbook. 7th ed. Philadelphia, PA: Elsevier; 2020:chap 7.Nattel S, Tomaselli GF. Mechanisms of cardiac arrhythmias. In: Libby P, Bonow RO, Mann DL, Tomaselli GF, Bhatt DL, Solomon SD, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 12th ed. Philadelphia, PA: Elsevier; 2022:chap 62.Olgin JE. Approach to the patient with suspected arrhythmia. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 26th ed. Philadelphia, PA: Elsevier; 2020:chap 56.AllVideoImagesTogCardiac conduction systemAnimation No audio descriptionWith audio descriptionRelated video goes here for no-HTML5 browsersRelated video goes here for no-HTML5 browsersCardiac conduction system - Animation A network of specialized muscle cells is found in the heart's walls. These muscle cells send signals to the rest of the heart muscle causing a contraction. This group of muscle cells is called the cardiac conduction system. The main parts of the system are the SA node, AV node, bundle of HIS, bundle branches, and Purkinje fibers. Let's follow a signal through the contraction process. The SA node starts the sequence by causing the atrial muscles to contract. That's why doctors sometimes call it the anatomical pacemaker. Next, the signal travels to the AV node, through the bundle of HIS, down the bundle branches, and through the Purkinje fibers, causing the ventricles to contract. This signal creates an electrical current that can be seen on a graph called an electrocardiogram, or EKG. Doctors use an EKG to see how well the cardiac conduction system works. Any changes on the EKG can mean serious problems.Cardiac arrhythmia: Additional testsAnimation Related video goes here for no-HTML5 browsersCardiac arrhythmia: Additional tests - Animation Additional tests are sometimes used to evaluate patients with arrhythmia. The most common tests are long-term ECG recording, exercise testing, heart rate variability, electrophysiological studies, echocardiography and Doppler ultrasound tests, and blood tests. The choice of which test to use depends on the clinical circumstances.Heart - front view - illustration The external structures of the heart include the ventricles, atria, arteries and veins. Arteries carry blood away from the heart while veins carry blood into the heart. The vessels colored blue indicate the transport of blood with relatively low content of oxygen and high content of carbon dioxide. The vessels colored red indicate the transport of blood with relatively high content of oxygen and low content of carbon dioxide.Heart - front viewillustrationConduction system of the heart - illustration The intrinsic conduction system sets the basic rhythm of the beating heart by generating impulses which stimulate the heart to contract.Conduction system of the heartillustrationCardiac conduction systemAnimation No audio descriptionWith audio descriptionRelated video goes here for no-HTML5 browsersRelated video goes here for no-HTML5 browsersCardiac conduction system - Animation A network of specialized muscle cells is found in the heart's walls. These muscle cells send signals to the rest of the heart muscle causing a contraction. This group of muscle cells is called the cardiac conduction system. The main parts of the system are the SA node, AV node, bundle of HIS, bundle branches, and Purkinje fibers. Let's follow a signal through the contraction process. The SA node starts the sequence by causing the atrial muscles to contract. That's why doctors sometimes call it the anatomical pacemaker. Next, the signal travels to the AV node, through the bundle of HIS, down the bundle branches, and through the Purkinje fibers, causing the ventricles to contract. This signal creates an electrical current that can be seen on a graph called an electrocardiogram, or EKG. Doctors use an EKG to see how well the cardiac conduction system works. Any changes on the EKG can mean serious problems.Cardiac arrhythmia: Additional testsAnimation Related video goes here for no-HTML5 browsersCardiac arrhythmia: Additional tests - Animation Additional tests are sometimes used to evaluate patients with arrhythmia. The most common tests are long-term ECG recording, exercise testing, heart rate variability, electrophysiological studies, echocardiography and Doppler ultrasound tests, and blood tests. The choice of which test to use depends on the clinical circumstances.Heart - front view - illustration The external structures of the heart include the ventricles, atria, arteries and veins. Arteries carry blood away from the heart while veins carry blood into the heart. The vessels colored blue indicate the transport of blood with relatively low content of oxygen and high content of carbon dioxide. The vessels colored red indicate the transport of blood with relatively high content of oxygen and low content of carbon dioxide.Heart - front viewillustrationConduction system of the heart - illustration The intrinsic conduction system sets the basic rhythm of the beating heart by generating impulses which stimulate the heart to contract.Conduction system of the heartillustration Tests for Intracardiac electrophysiology study (EPS) Intracardiac electrophysiology study (EPS)Related Information Arrhythmias(Condition)Holter monitor (24h)(Medical Test)Sick sinus syndrome(Condition)Wolff-Parkinson-White syndrome (WPW)(Condition)Ventricular tachycardia(Condition)Cardiac ablation procedures (Surgery) Review Date: 5/8/2022 Reviewed By: Michael A. Chen, MD, PhD, Associate Professor of Medicine, Division of Cardiology, Harborview Medical Center, University of Washington Medical School, Seattle, WA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team. The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. No warranty of any kind, either expressed or implied, is made as to the accuracy, reliability, timeliness, or correctness of any translations made by a third-party service of the information provided herein into any other language. © 1997- A.D.A.M., a business unit of Ebix, Inc. Any duplication or distribution of the information contained herein is strictly prohibited. © 1997- All rights reserved. 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Intracardiac electrophysiology study (EPS)Electrophysiology study - intracardiac; EPS - intracardiac; Abnormal heart rhythms - EPS; Bradycardia - EPS; Tachycardia - EPS; Fibrillation - EPS; Arrhythmia - EPS; Heart block - EPSIntracardiac electrophysiology study (EPS) is a test to look at how well the heart's electrical signals are working. It is used to evaluate abnormal heartbeats or heart rhythms.Heart rhythmsAn arrhythmia is a disorder of the heart rate (pulse) or heart rhythm. The heart can beat too fast (tachycardia), too slow (bradycardia), or irregul...ImageRead Article Now Book Mark Article Related video goes here for no-HTML5 browsers How the Test is Performed Wire electrodes are placed in the heart to do this test. These electrodes measure electrical activity in the heart.The procedure is done in a hospital laboratory. The staff will include a cardiologist, technicians, and nurses. To have this study:Your groin and/or neck area will be cleaned and numbing medicine (anesthetic) will be applied to the skin. The cardiologist will then place several IVs (called sheaths) into the groin or neck area. Once these IVs are in place, wires or electrodes can be passed through the sheaths into your body. The doctor uses moving x-ray images (fluoroscopy) to guide the catheter into the heart and place the electrodes in the right places. The electrodes pick up the heart's electrical signals. Electrical signals from the electrodes may be used to make the heart skip beats or produce an abnormal heart rhythm. This can help the doctor understand more about what is causing the abnormal heart rhythm or where in the heart it is starting. You may also be given medicines that may also be used for the same purpose. Other procedures that may also be done during the test:Placement of a heart pacemaker PacemakerA pacemaker is a small, battery-operated device. This device senses when your heart is beating too slowly. It sends a signal to your heart that mak...ImageRead Article Now Book Mark Article Procedure to modify small areas in your heart that may be causing your heart rhythm problems (called catheter ablation) Catheter ablationCardiac ablation is a procedure that is used to scar small areas in your heart that may be involved in your heart rhythm problems. This can prevent ...Read Article Now Book Mark Article No audio descriptionWith audio descriptionRelated video goes here for no-HTML5 browsersRelated video goes here for no-HTML5 browsers How to Prepare for the Test You will be told not to eat or drink for 6 to 8 hours before the test. You will wear a hospital gown. You must sign a consent form for the procedure.Your health care provider will tell you ahead of time if you need to make changes to the medicines you regularly take. Do not stop taking or change any medicines without first talking to your provider.In most cases, you will be given medicine to help you feel calm before the procedure. The study can last from 1 hour up to several hours. You may not be able to drive home afterward, so you should plan for someone to drive you. How the Test will Feel You will be awake during the test. You may feel some discomfort when the IV is placed into your arm. You may also feel some pressure at the site when the catheter is inserted. You may feel your heart skipping beats or racing at times. Why the Test is Performed Your provider may order this test if you have signs of an abnormal heart rhythm (arrhythmia).ArrhythmiaAn arrhythmia is a disorder of the heart rate (pulse) or heart rhythm. The heart can beat too fast (tachycardia), too slow (bradycardia), or irregul...ImageRead Article Now Book Mark Article You may need to have other tests before this study is done. An EPS may be done to:Test the function of your heart's electrical system Pinpoint a known abnormal heart rhythm (arrhythmia) that is starting in the heart Decide the best therapy for an abnormal heart rhythm Determine whether you are at risk for future heart events, especially sudden cardiac death See if medicine is controlling an abnormal heart rhythm See whether you need a pacemaker or implantable cardioverter-defibrillator (ICD) Implantable cardioverter-defibrillatorAn implantable cardioverter-defibrillator (ICD) is a device that detects a life-threatening, rapid heartbeat. This abnormal heartbeat is called an a...ImageRead Article Now Book Mark Article What Abnormal Results Mean Abnormal results may be due to abnormal heart rhythms that are too slow or too fast. These may include:Atrial fibrillation or flutter Atrial fibrillationAtrial fibrillation (Afib) and atrial flutter are common types of abnormal heart rhythms (arrhythmias) which affect the upper chambers (atria) of the...ImageRead Article Now Book Mark Article Heart block Sick sinus syndrome Sick sinus syndromeNormally, the heartbeat starts in an area in the top chambers of the heart (atria). This area is the heart's pacemaker. It is called the sinoatrial...ImageRead Article Now Book Mark Article Supraventricular tachycardia (a collection of abnormal heart rhythms that start in the upper chambers of the heart) Supraventricular tachycardiaParoxysmal supraventricular tachycardia (PSVT) is episodes of a rapid heart rate that start in a part of the heart above the ventricles. "Paroxysmal...ImageRead Article Now Book Mark Article Ventricular fibrillation and ventricular tachycardia Ventricular tachycardiaVentricular tachycardia (VT) is a rapid heartbeat that starts in the lower chambers of the heart (ventricles).ImageRead Article Now Book Mark Article Wolff-Parkinson-White syndromeWolff-Parkinson-White syndromeWolff-Parkinson-White (WPW) syndrome is a condition in which there is an extra electrical pathway in the heart that leads to periods of rapid heart r...ImageRead Article Now Book Mark Article There may be other causes that are not on this list.The provider must find the location and type of heart rhythm problem in order to determine the proper treatment. Risks The procedure is very safe in most cases. Possible risks include:Arrhythmias Bleeding Blood clots that lead to embolism EmbolismBlood clots are clumps that occur when blood hardens from a liquid to a solid. A blood clot that forms inside one of your veins or arteries is calle...ImageRead Article Now Book Mark Article Cardiac tamponade Cardiac tamponadeCardiac tamponade is pressure on the heart that occurs when blood or fluid builds up in the space between the heart muscle and the outer covering sac...ImageRead Article Now Book Mark Article Heart attack Heart attackMost heart attacks are caused by a blood clot that blocks one of the coronary arteries. The coronary arteries bring blood and oxygen to the heart. ...ImageRead Article Now Book Mark Article Infection Injury to the vein Low blood pressure Low blood pressureLow blood pressure occurs when blood pressure is much lower than normal. This means the heart, brain, and other parts of the body may not get enough...ImageRead Article Now Book Mark Article Stroke Open ReferencesReferencesFerreira SW, Mehdirad AA. The electrophysiology laboratory and electrophysiologic procedures. In: Sorajja P, Lim MJ, Kern MJ, eds. Kern's Cardiac Catheterization Handbook. 7th ed. Philadelphia, PA: Elsevier; 2020:chap 7.Nattel S, Tomaselli GF. Mechanisms of cardiac arrhythmias. In: Libby P, Bonow RO, Mann DL, Tomaselli GF, Bhatt DL, Solomon SD, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 12th ed. Philadelphia, PA: Elsevier; 2022:chap 62.Olgin JE. Approach to the patient with suspected arrhythmia. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 26th ed. Philadelphia, PA: Elsevier; 2020:chap 56.